In Groovy, for example, you have the equivalent of macros in the form of AST Transformations †, that look just like Java annotations, but can actually convert the code their are applied to (or, more specifically, the AST node) and transform it into something else at compile time. Writing AST Transformations in Groovy is not as smooth as writing macros in Lisp, as you have to deal with the AST nodes as objects (there are DSLs for this fortunately), instead of using the same language syntax directly, but they provide awesome metaprogramming capabilities as well. The Groovy standard library includes some very useful AST Transformations and frameworks like Grails use them to a great extent too.
So, i think that, even though macros (or equivalent code transformations) are not very accessible to the average programmer if the language does not have homoiconicity, they can be of great value for library writers. As the linked article shows, they could be used to make something that looks like jQuery but generates much more efficient code :D
† http://groovy.codehaus.org/Compile-time+Metaprogramming+-+AS...
